Direct sequence identification of mutations by cleavage- and ligation-associated mutation-specific sequencing

ABSTRACT

The present invention provides methods for identifying the presence, location and sequence of one or more genetic alterations in one or more DNA molecules. Further provided are methods for positional cloning of a gene of interest.

FIELD OF THE INVENTION

This invention pertains to high-throughput methodology that directly identifies previously unidentified sequence alterations in DNA, including specific disease-causing DNA sequences in mammals. The methods of the present invention can be used to identify genetic polymorphisms, to determine the molecular basis for genetic diseases, and to provide carrier and prenatal diagnosis for genetic counseling.

BACKGROUND OF THE INVENTION

The ability to detect alterations in DNA sequences (e.g. mutations and polymorphisms) is central to the diagnosis of genetic diseases and to the identification of clinically significant variants of disease-causing microorganisms. One method for the molecular analysis of genetic variation involves the detection of restriction fragment length polymorphisms (RFLPs) using the Southern blotting technique (Southern, E. M., J. Mol. Biol., 98:503-517, 1975. Since this approach is relatively cumbersome, new methods have been developed, some of which are based on the polymerase chain reaction (PCR). These include: RFLP analysis using PCR (Chehab et at., Nature, 329:293-294, 1987; Rommens et al., Am. J. Hum. Genet., 46:395-396, 1990), the creation of artificial RFLPs using primer-specified restriction-site modification (Haliassos et at., Nucleic Acids Research, 17:3606, 1989), allele-specific amplification (ASA) (Newton CR et al., Nuc. Acids Res., 17:2503-2516, 1989), oligonucleotide ligation assay (OLA) (Landergren U et at., Science 241:1077-1080, 1988), primer extension (Sokolov BP, Nucl. Acids Res., 18:3671, 1989), artificial introduction of restriction sites (AIRS) (Cohen LB et al., Nature 334:119-121, 1988), allele-specific oligonucleotide hybridization (ASO) (Wallace RB et at., Nucl. Acids Res., 9:879-895, 1981) and their variants. Together with robotics, these techniques for direct mutation and analysis have helped in reducing cost and increasing throughput when only a limited number of mutations need to be analyzed for efficient diagnostic analysis.

These methods are, however, limited in their applicability to complex mutational analysis. For example, in cystic fibrosis, a recessive disorder affecting 1 in 2000-2500 live births in the United States, more than 225 presumed disease-causing mutations have been identified. Furthermore, multiple mutations may be present in a single affected individual, and may be spaced within a few base pairs of each other. These phenomena present unique difficulties in designing clinical screening methods that can accommodate large numbers of sample DNAs.

Co-pending U.S. patent application Ser. No. 07/957,205 of Shuber et al. and Shuber et at., Human Molecular Genetics, 2:153-158, 1993, disclose a method that allows the simultaneous hybridization of multiple oligonucleotide probes to a single target DNA sample. By including in the hybridization reaction an agent that eliminates the disparities in melting temperatures of hybrids formed between synthetic oligonucleotides and target DNA, it is possible in a single test to screen a DNA sample for the presence of different mutations. Typically, more than 100 ASOs can be pooled and hybridized to target DNA; in a second step, ASOs from a pool giving a positive result are individually hybridized to the same DNA. Co-pending U.S. patent application Ser. No. 08/281,940 discloses a method for multiple allele-specific disease analysis in which multiple ASOs are first hybridized to a target DNA, followed by elution and sequencing of ASOs that hybridize. This method allows the identification of a mutation without the need for many individual hybridizations involving single ASOs and requires prior knowledge of relevant mutations.

To achieve adequate detection frequencies for rare mutations using the above methods, however, large numbers of mutations must be screened. To identify previously unknown mutations within a gene, other methodologies have been developed, including: single-strand conformational polymorphisms (SSCP) (Orita M et at., Proc. Natl. Acad. Sci. U.S.A. 86:2766-2770, 1989), denaturing gradient gel electrophoresis (DGGE) (Meyers RM et al., Nature 313:495-498, 1985), heteroduplex analysis (HET) (Keen j. et al., Trends Genet. 7:5, 1991), chemical cleavage analysis (CCM) (Cotton RGH et al., Proc. Natl. Acad. Sci., 85:4397-4401, 1988), and complete sequencing of the target sample (Maxam AM et al., Methods Enzymol. 65:499-560, 1980, Sanger F. et al., Proc. Natl. Acad. Sci. U.S.A. 74:5463-5467, 1977). All of these procedures however, with the exception of direct sequencing, are merely screening methodologies. That is, they merely indicate that a mutation exists, but cannot specify the exact sequence and location of the mutation. Therefore, identification of the mutation ultimately requires complete sequencing of the DNA sample. For this reason, these methods are incompatible with high-throughput and low-cost routine diagnostic methods.

Thus, there is a need in the art for a relatively low cost method that allows the efficient analysis of large numbers of DNA samples for the presence of previously unidentified mutations or sequence alterations.

SUMMARY OF THE INVENTION

The present invention encompasses high-throughput methods for identifying one or more genetic alterations in a target DNA sequence present in a DNA sample. The method is carried out by the steps of:

a) cleaving the DNA at or in the vicinity of the alteration, forming new ends;

b) ligating an oligonucleotide of predetermined sequence to the new ends;

c) determining the nucleotide sequence adjacent to the ligated oligonucleotide; and

d) comparing the nucleotide sequence determined in c) with a predetermined cognate wild-type sequence to identify the alteration.

Specific cleavage at or near the alteration is achieved by hybridizing the target DNA with a second DNA sample not containing the alteration, so that hybrids are formed that contain mismatch regions, which can be recognized and cleaved by mismatch recognition systems.

Typically, the target DNA sample being tested comprises genomic DNA from a patient suffering from a genetic disease whose genome does not contain any of the known mutations that cause that disease, and the second DNA sample comprises a known disease-causing gene. The genetic alterations that may be identified by these methods include additions, deletions, or substitutions of one or more nucleotides. Any mismatch recognition and cleavage system may be used in practicing the invention, including without limitation bacteriophage resolvases, mismatch repair proteins, nucleotide excision repair proteins, chemical modification and cleavage, and combinations of these systems.

The present invention finds application in high-throughput methods for multiplex identification of new disease-causing mutations or previously unidentified polymorphisms, in which DNAs obtained from a multiplicity of patients are immobilized on a single solid support, followed by the hybridization, mismatch recognition/cleavage, ligation, sequencing, and sequence comparison steps as set forth above. Furthermore, multiple specific target sequences can be analyzed simultaneously by amplifying the target sequences prior to immobilization, followed by the hybridization, mismatch recognition/cleavage, ligation, sequencing, and sequence comparison steps as set forth above.

DETAILED DESCRIPTION OF THE INVENTION

All patent applications, patents, and literature references cited in this specification are hereby incorporated by reference in their entirety. In case of conflict, the present description, including definitions, will control.

The present invention encompasses high-throughput methods for identifying specific DNA sequences in DNA isolated from a patient. As used herein, the term high-throughput refers to a system for rapidly assaying large numbers of DNA samples at the same time. The methods are applicable when one or more genes or genetic loci are targets of interest. The specific sequences typically contain one or more sequence alterations relative to wild-type DNA, including additions, deletions, or substitutions of one or more nucleotides.

In practicing the methods of the present invention, the target DNA sequence is hybridized with a sample of DNA (or a pool of DNA samples) containing one or more wild-type versions of the target gene. The methods of the present invention take advantage of the physico-chemical properties of DNA hybrids between almost-identical (but not completely identical) DNA strands (i.e., heteroduplexes). When a sequence alteration is present, the heteroduplexes contain a mismatch region that is embedded in an otherwise perfectly matched hybrid. According to the present invention, mismatch regions are formed under controlled conditions and are chemically and/or enzymatically modified; the sequences adjacent to, and including, the mismatch are then determined. Depending upon the mismatch recognition method used, the mismatch region may comprise any number of bases, preferably from 1 to about 1000 bases. The methods of the invention can be employed to identify specific disease-causing mutations in individual patients (when the gene or genes responsible for the disease are known) and for positional cloning to identify new disease-causing genes.

In a preferred embodiment, the specific DNA sequence comprises a portion of a particular gene or genetic locus in the patient's genomic DNA known to be involved in a pathological condition or syndrome. Non-limiting examples of genetic syndromes include cystic fibrosis, sickle-cell anemia, thalassemias, Gaucher's disease, adenosine deaminase deficiency, alpha1-antitrypsin deficiency, Duchenne muscular dystrophy, familial hypercholesterolemia, fragile X syndrome, glucose-6-phosphate dehydrogenase deficiency, hemophilia A, Huntington disease, myotonic dystrophy, neurofibromatosis type 1, osteogenesis imperfecta, phenylketonuria, retinoblastoma, Tay-Sachs disease, and Wilms tumor (Thompson and Thompson, Genetics in Medicine, 5th Ed.).

In another embodiment, the specific DNA sequence comprises part of a particular gene or genetic locus that may not be known to be linked to a particular disease, but in which polymorphism is known or suspected. For example, obesity may be linked with variations in the apolipoprotein B gene, hypertension may be due to genetic variations in sodium or other transport systems, aortic aneurysms may be linked to variations in α-haptoglobin and cholesterol ester transfer protein, and alcoholism may be related to variant forms of alcohol dehydrogenase and mitochondrial aldehyde dehydrogenase. Furthermore, an individual's response to medicaments may be affected by variations in drug modification systems such as cytochrome P450s, and susceptibility to particular infectious diseases may also be influenced by genetic status. Finally, the methods of the present invention can be applied to HLA analysis for identity testing.

In yet another embodiment, the specific DNA sequence comprises part of a foreign genetic sequence e.g. the genome of an invading microorganism. Non-limiting examples include bacteria and their phages, viruses, fungi, protozoa, and the like. The present methods are particularly applicable when it is desired to distinguish between different variants or strains of a microorganism in order to choose appropriate therapeutic interventions.

The methods of the present invention encompass the steps of:

1) preparing heteroduplexes between patients' DNA and wild-type DNA;

2) cleaving mismatches;

3) ligating a synthetic oligonucleotide to the end of a cleaved fragment; and

4) determining the precise sequence that is altered. These steps are described in detail below.

1. PREPARATION OF HETERODUPLEXES

In accordance with the present invention, the target DNA represents a sample of DNA isolated from an animal or human patient. This DNA may be obtained from any cell source or body fluid. Non-limiting examples of cell sources available in clinical practice include blood cells, buccal cells, cervicovaginal cells, epithelial cells from urine, fetal cells, or any cells present in tissue obtained by biopsy. Body fluids include blood, urine, cerebrospinal fluid, and tissue exudates at the site of infection or intimation. DNA is extracted from the cell source or body fluid using any of the numerous methods that are standard in the art. It will be understood that the particular method used to extract DNA will depend on the nature of the source. The preferred amount of DNA to be extracted for analysis of human genomic DNA is at least 5 pg (corresponding to about 1 cell equivalent of a genome size of 4×10⁹ base pairs). In some applications, such as, for example, detection of sequence alterations in the genome of a microorganism, variable amounts of DNA may be extracted.

Once extracted, the target DNA may be employed in the present invention without further manipulation. Preferably, one or more specific DNA regions present in the target DNA may be amplified by PCR. In this case, the amplified regions are specified by the choice of particular flanking sequences for use as primers. Amplification at this step provides the advantage of increasing the concentration of specific DNA sequences within the target DNA sequence population. The length of DNA sequence that can be amplified ranges from 80 bp to up to 30 kbp (Saiki et al., 1988, Science, 239:487). Furthermore, the use of amplification primers that are modified by, e.g., biotinylation, allows the selective incorporation of the modification into the amplified target DNA.

In one embodiment, the target DNA, with or without prior amplification of particular sequences, is bound to a solid-phase matrix. This allows the simultaneous processing and screening of a large number of patient samples. Non-limiting examples of matrices suitable for use in the present invention include nitrocellulose or nylon filters, glass beads, magnetic beads coated with agents for affinity capture, treated or untreated microtiter plates, and the like. It will be understood by a skilled practitioner that the method by which the target DNA is bound to the matrix will depend on the particular matrix used. For example, binding to nitrocellulose can be achieved by simple adsorption of DNA to the filter, followed by baking the filter at 75°-80° C. under vacuum for 15 min-2h. Alternatively, charged nylon membranes can be used that do not require any further treatment of the bound DNA. Beads and microtiter plates that are coated with avidin can be used to bind target DNA that has had biotin attached (via e.g. the use of biotin-conjugated PCR primers.) In addition, antibodies can be used to attach target DNA to any of the above solid supports by coating the surfaces with the antibodies and incorporating an antibody-specific hapten into the target DNA. In a preferred embodiment, target DNA that has been amplified using biotinylated primers is bound to streptavidin-coated beads (Dynal, Inc., Milwaukee, Wis.).

In practicing the present invention, the untreated or amplified target DNA, preferably bound to a solid-phase matrix, is hybridized with a second DNA sample under conditions that favor the formation of mismatch loops. The second DNA sample preferably comprises one or more "wild-type" version(s) of the target DNA sequence. As used herein, a "wild-type" version of a gene is one prevalent in the general population that is not associated with disease (or with any discernable phenotype) and is thus carried by "normal" individuals. In the general population, wild-type genes may include multiple prevalent versions, which contain alterations in sequence relative to each other that cause no discernable pathological effect; these variations are designated "polymorphisms" or "allelic variants". Most preferably, a mixture of DNAs from "normal" individuals is used for the second DNA sample, thus providing a mixture of the most common polymorphisms. This insures that, statistically, hybrids formed between the first and second DNA sample will be perfectly matched except in the region of the mutation, where discrete mismatch regions will form. In some applications, it is desired to detect polymorphisms; in these cases, appropriate sources for the second DNA sample will be selected accordingly. Depending upon what method is used subsequently to detect mismatches, the wild-type DNA may also be chemically or enzymatically modified, e.g., to remove or add methyl groups.

Hybridization reactions according to the present invention are performed in solutions ranging from about 10 mM NaCl to about 600 mM NaCl, at temperatures ranging from about 37° C. to about 65° C. It will be understood that the stringency of a hybridization reaction is determined by both the salt concentration and the temperature; thus, a hybridization performed in 10 mM salt at 37° C. may be of similar stringency to one performed in 500 mM salt at 65° C. For the purposes of the present invention, any hybridization conditions may be used that form perfect hybrids between precisely complementary sequences and mismatch loops between non-complementary sequences in the same molecules. Preferably, hybridizations are performed in 600 mM NaCl at 65° C. Following the hybridization step, DNA molecules that have not hybridized to the target DNA sample are removed by washing under stringent conditions, e.g. , 0.1X SSC at 65° C.

The hybrids formed by the hybridization reaction may then be treated to block any free ends so that they cannot serve as substrates for further enzymatic modification such as, e.g., by RNA ligase. Suitable blocking methods include without limitation removal of 5' phosphate groups, homopolymeric tailing of 3' ends with dideoxynucleotides, and ligation of modified double-stranded oligonucleotides to the ends of the duplex.

2. MISMATCH RECOGNITION AND CLEAVAGE

In the next step, the hybrids are treated so that one or both DNA strands are cleaved within, or in the vicinity of, the mismatch region. Depending on the method used for mismatch recognition and cleavage (see below), cleavage may occur at the precise site of mismatch or at some predetermined distance from either boundary of the mismatch region. The "vicinity" of the mismatch as used herein thus encompasses from 1 to 2000 bases from the borders of the mismatch. Furthermore, when cleavage is restricted to one strand, it may occur on the wild-type or mutant strand. Non-limiting examples of mismatch recognition and cleavage systems suitable for use in the present invention include bacteriophage resolvases, mismatch repair proteins, nucleotide excision repair proteins, chemical modification, and combinations thereof. These embodiments are described below.

In general, the mismatch recognition and/or modification proteins necessary for each embodiment described below are isolated using methods that are well known to those skilled in the art. Preferably, when the sequence of a protein is known, the protein-coding region of the relevant gene is isolated from the source organism by subjecting genomic DNA of the organism to PCR using appropriate primers. The isolated protein-coding DNA sequence is cloned into commercially available expression vectors that, e.g., insert an amino acid "purification tag" at either the amino- or carboxyterminus of the recombinant protein. The recombinant expression vector is then introduced into an appropriate host cell (e.g., E. coli), and the protein is recovered from the cell lysate by affinity chromatography that recognizes the "tag". For example, the bacterial expression vector pQiex12 is used to express proteins with a polyhistidine tag, allowing purification of the recombinant product by a single step of chromatography on Ni-SEPHAROSE™ beads (QiaGen, Chatsworth, Calif.). Other methods involve the expression of recombinant proteins carrying glutathione-S-transferase sequences as tags, allowing purification of the recombinant products on glutathione affinity columns (Pharmacia Biotech, Uppsala, Sweden). If necessary, proteins containing purification tags are then treated so as to remove the tag sequences. Alternatively, the protein may be isolated from its cell of origin using standard protein purification techniques well-known in the art, including, e.g. , molecular sieve, ion-exchange, and hydrophobic chromatography; and isoelectric focusing. "Isolation" as used herein denotes purification of the protein to the extent that it can carry out its function in the context of the present invention without interference from extraneous proteins or other contaminants derived from the source cells.

The mismatch recognition and modification proteins used in practicing the present invention may be derived from any species, from E. coli to humans, or mixtures thereof. Typically, functional homologues for a given protein exist across phylogeny. A "functional homologue" of a given protein as used herein is another protein that can functionally substitute for the first protein, either in vivo or in a cell-free reaction.

Resolvases

Resolvases are enzymes that catalyze the resolution of branched DNA intermediates that form during recombination events (including Holliday structures, cruciforms, and loops) via recognition of bends, kinks, or DNA deviations (Youil et al., Proc. Natl. Acad. Sci. U.S.A. 92:87, 1995). For example, Endonuclease VII derived from bacteriophage T4 (T4E7) recognizes mismatch regions of from one to about 50 bases and produces double-stranded breaks within six nucleotides from the 3' border of the mismatch region. T4E7 may be isolated from, e.g., a recombinant E. coil that overexpresses gene 49 of T4 phage (Kosak et al., Eur. J. Biochem. 194:779, 1990). Another suitable resolvase for use in the present invention is Endonuclease I of bacteriophage T7 (T7E1), which can be isolated using a polyhistidine purification tag sequence (Mashal et al., Nature Genetics 9: 177, 1995).

In a preferred embodiment, heteroduplexes formed between patients' DNA and wild-type DNA as described above are incubated in a 50 μl reaction with 100-3000 units of T4E7 for 1 hour at 37° C.

Misraatch Repair Proteins

A number of different enzyme systems exist across phylogeny to repair mismatches that form during DNA replication. In E. coli, one system involves the MutY gene product, which recognizes A/G mismatches and cleaves the A-containing strand (Tsai-Wu et al., J. Bacteriol. 178: 1902, 1991). Another system in E. coli utilizes the coordinated action of the MutS, MutL, and MutH proteins to recognize errors in newly-synthesized DNA strands specifically by virtue of their transient state of undermethylation (prior to their being acted upon by dam methylase in the normal course of replication). Cleavage typically occurs at a hemimethylated GATC site within 1-2 kb of the mismatch, followed by exonucleolytic cleavage of the strand in either a 3'-5' or 5'-3' direction from the nick to the mismatch. In vivo, this is followed by re-synthesis involving DNA polymerase III holoenzyme and other factors (Cleaver, Cell, 76:1-4, 1994).

Mismatch repair proteins for use in the present invention may be derived from E. coli (as described above) or from any organism containing mismatch repair proteins with appropriate functional properties. Non-limiting examples of useful proteins include those derived from Salmonella typhimurium (MutS, MutL); Streptococcus pneumoniae (HexA, HexB); Saccharomyces cerevisiae ("all-type", MSH2, MLH1, MSH3); Schizosaccharomyces pombe (SWI4); mouse (rep1, rep3); and human ("all-type", hMSH2, hMLH1, hPMS1, hPMS2, duc1). Preferably, the "all-type" mismatch repair system from human or yeast cells is used (Chang et at., Nuc. Acids Res. 19:4761, 1991; Yang et at., J. Biol. Chem. 266:6480,1991). In a preferred embodiment, heteroduplexes formed between patients' DNA and wild-type DNA as described above are incubated with human "all-type" mismatch repair activity that is purified essentially as described in International Patent Application WO/93/20233. Incubations are performed in, e.g., 10 mM Tris-HCl pH 7.6, 10 mM ZnCl₂, 1 mM dithiothreitol, 1 mM EDTA and 2.9% glycerol at 37° C. for 1-3 hours. In another embodiment, purified MutS, MutL, and MutH are used to cleave mismatch regions (Su et al., Proc. Natl. Acad. Sci. U.S.A. 83:5057,1986; Grulley et at., J. Biol. Chem. 264: 1000, 1989).

Nucleotide Excision Repair Proteins

In E. coIi, four proteins, designated UvrA, UvrB, UvrC, and UvrD, interact to repair nucleotides that are damaged by UV light or otherwise chemically modified (Sancar, Science 266: 1954, 1994), and also to repair mismatches (Huang et al., Proc. Natl. Acad. Sci. U.S.A. 91: 12213, 1994). UvrA, an ATPase, makes an A₂ B₁ complex with UvrB, binds to the site of the lesion, unwinds and kinks the DNA, and causes a conformational change in UvrB that allows it to bind tightly to the lesion site. UvrA then dissociates from the complex, allowing UvrC to bind. UvrB catalyzes an endonucleolytic cleavage at the fifth phosphodiester bond 3' from the lesion; UvrC then catalyzes a similar cleavage at the eighth phosphodiester bond 5' from the lesion. Finally, UvrD (helicase II) releases the excised oligomer. In vivo, DNA polymerase I displaces UvrB and fills in the excision gap, and the patch is ligated.

In one embodiment of the present invention, heteroduplexes formed between patients' DNA and wild-type DNA are treated with a mixture of UvrA, UvrB, UvrC, with or without UvrD. As described above, the proteins may be purified from wild-type E. coli, or from E. coli or other appropriate host cells containing recombinant genes encoding the proteins, and are formulated in compatible buffers and concentrations. The final product is a heteroduplex containing a single-stranded gap covering the site of the mismatch.

Excision repair proteins for use in the present invention may be derived from E. coli (as described above) or from any organism containing appropriate functional homologues. Non-limiting examples of useful homologues include those derived from S. cerevisiae (RAD1, 2, 3, 4, 10, 14, and 25) and humans (XPF, XPG, XPD, XPC, XPA, ERCC1, and XPB) (Sancar, Science 266: 1954, 1994). When the human homologues are used, the excised patch comprises an oligonucleotide extending 5 nucleotides from the 3' end of the lesion and 24 nucleotides from the 5' end of the lesion. Aboussekhra et al. (Cell 80:859, 1995) disclose a reconstituted in vitro system for nucleotide excision repair using purified components derived from human cells.

Chemical Mismatch Recognition

Heteroduplexes formed between patients' DNA and wild-type DNA according to the present invention may be chemically modified by treatment with osmium tetroxide (for mispaired thymidines) and hydroxylamine (for mispaired cytosines), using procedures that are well known in the art (see, e.g., Grompe, Nature Genetics 5:111, 1993; and Saleeba et at., Meth. Enzymol. 217:288, 1993). In one embodiment, the chemically modified DNA is treated with piperidine, which results in strand breakage at the modified base. In another, preferred, embodiment, the chemically modified DNA is contacted with excision repair proteins (as described above), which recognize the hydroxylamine- or osmium-modified bases as damaged bases in need of repair. In either case, selective cleavage of one DNA strand occurs.

3. SEQUENCE DETERMINATION

In practicing the present invention, immobilized target DNA from a patient is hybridized to wild-type DNA to form mismatch regions and then treated with mismatch repair proteins, excision repair proteins, resolvases, chemical modification and cleavage reagents, or combinations of such agents, to introduce single- or double-stranded breaks at some predetermined location relative to the site of the mismatch regions. The hybrids formed between the wild-type DNA and the patient's DNA are then dissociated by denaturation, and the wild-type DNA and any cleavage products of the target DNA are removed by washing.

The immobilized remaining target DNA is then ligated to a synthetic single-stranded oligonucleotide of predetermined sequence, designated a "ligation oligonucleotide", that serves as a primer for enzymatic DNA sequencing. The oligonucleotide may be from about 15 to about 25 nucleotides in length. A preferred ligation oligonucleotide has the sequence 5'-CAGTAGTACAACTGACCCTTTTGGGACCGC-3' SEQ ID NO:1!. Ligation is achieved using, e.g., RNA ligase (Pharmacia Biotech, Uppsala, Sweden). A typical ligation reaction is performed at 37° C. for 15 min in a 20 μl reaction containing 50 mM Tris-HCl pH 7.5, 10 mM MgCl₂, 20 mM diothiothreitol, 1 mM ATP, 100 μg/ml bovine serum albumin, at least 1 μg immobilized target DNA, a 10-fold molar excess of the ligation oligonucleotide, and 0.1∝5.0 units/ml T4 RNA ligase. Following the ligation, unligated oligonucleotides are removed by washing.

The sequence of DNA immediately adjacent to the ligated oligonucleotide is then determined by any method known in the art. In one embodiment, enzymatic sequencing is performed according to the dideoxy Sanger technique, using as a sequencing primer a second oligonucleotide of predetermined sequence that is complementary to the ligation oligonucleotide (Sanger et al., Proc. Natl. Acad. Sci. U.S.A. 74:5463, 1977). Each microsequencing reaction is then resolved by techniques well-known in the art, including without limitation gel electrophoresis, and the sequence is determined.

In another embodiment, an oligonucleotide complementary to the ligated oligonucleotide is used to prime DNA synthesis using DNA polymerase I in the presence of all four nucleoside triphosphates. The newly synthesized strand is then analyzed using hybridization to oligonucleotide arrays as described in Pease et at., Proc. Natl. Acad. Sci. U.S.A. 91:5022, 1994.

Identification of a sequence alteration according to the present invention is preferably achieved in a single round of mismatch recognition and cleavage, oligonucleotide ligation, and DNA sequencing. This occurs when the ligated oligonucleotide becomes covalently attached to a) the immobilized tnmcated target DNA that contains the alteration b) within 10-500 bp of either boundary of the mismatch region. If either of these conditions is not fulfilled, further rounds of sequencing may be required to localize and identify the sequence alteration. It will be understood by those of ordinary skill in the art that sequencing primers for one or more further rounds of sequencing will be dictated by the sequence obtained in the first round (either the same or complementary strands). Without wishing to be bound by theory, it is contemplated that one or two sequencing rounds will reveal the divergence between a known wild-type sequence and that contained within the DNA of a particular patient (see below).

High-Throughput Applications

The methods of the present invention are particularly suitable for high-throughput analysis of DNA, i.e., the rapid and simultaneous processing of DNA samples derived from a large number of patients. Furthermore, in contrast to other methods for de novo mutation detection, the methods of the present invention are suitable for the simultaneous analysis of a large number of genetic loci in a single reaction; this is designated "multiplex" analysis. Therefore, for any one sample or for a multiplicity of samples, the present invention allows the analysis of both intragenic loci (several regions within a single gene) and intergenic loci (several regions within different genes) in a single reaction mixture. The manipulations involved in practicing the methods of the present invention lend themselves to automation, e.g., using multiwell microtiter dishes as a solid support or as a receptacle for, e.g., beads; robotics to perform sequential incubations and washes; and, finally, automated sequencing using commercially available automated DNA sequencers. It is contemplated that, in a clinical context, 500 patient DNA samples can be analyzed within 1-2 days in a cost-effective manner (less than $50.00/sample).

Positional Cloning

The methods of the present invention are also suitable for positional cloning of unknown genes that cause pathological conditions or other detectable phenotypes in any organism. "Positional cloning" as used herein denotes a process by which a previously unknown disease-causing gene is localized and identified. For example, identification of multiplex families in which several members exhibit signs of a genetically-based syndrome often occurs even when the particular gene responsible for the syndrome has not been identified. Typically, the search for the unknown gene involves one or more of the following time- and labor-intensive steps: 1) cytogenetic localization of the gene to a relatively large segment of a particular chromosome; 2) assembly of overlapping cosmid or P1 clones that collectively cover several hundred thousand nucleotides corresponding to the identified chromosomal region; 3) sequencing the clones; and 4) transcript mapping to identify expressed protein-encoding regions of the gene.

The present invention offers an alternative, cost-effective method for localizing a disease-causing gene. Briefly, DNA from affected individuals is hybridized with normal DNA as described above to form mismatch regions at the site of the mutation. Preferably, large regions of DNA corresponding to the chromosomal location are amplified from the patient's genomic DNA prior to inclusion in the hybridization reaction. The hybrids are then treated by any of the methods described above so that mismatch regions are recognized and cleaved. Finally, the sequence in the vicinity of the mismatch region is determined after ligation of the sequencing oligonucleotide to the free ends formed in or near the mismatch region.

In this embodiment, determination of even a short sequence in the vicinity of the mismatch facilitates definitive identification of the disease-causing gene. The short sequence that is determined in the first round of sequencing can be used to design oligonucleotide probes for use in screening genomic or cDNA libraries. Other methods in which the primary sequence information can be used, either alone or in conjunction with library screening, include identification of tissue specific expression, reverse transcription-PCR amplification of mRNA, and screening of an affected population for genotype/phenotype association. Thus, without wishing to be bound by theory, it is contemplated that a previously unknown gene that causes a disease or other phenotype can be quickly and efficiently identified by these methods.

The following examples are intended to illustrate the present invention without limitation.

EXAMPLE 1 Preparation of Target DNA A) Preparation of Sample DNA from Blood

Whole blood samples collected in high glucose ACD Vacutainers™ (yellow top) were centrifuged and the buffy coat collected. The white cells were lysed with two washes of a 10:1 (v/v) mixture of 14 mM NH₄ Cl and 1 mM NaHCO₃, their nuclei were resuspended in nuclei-lysis buffer (10 mM Tris, pH 8.0, 0.4M NaCl, 2 mM EDTA, 0.5% SDS, 500 ug/ml proteinase K) and incubated overnight at 37° C. Samples were then extracted with a one-fourth volume of saturated NaCl and the DNA was precipitated in ethanol. The DNA was then washed with 70% ethanol, dried, and dissolved in TE buffer (10 mM Tris-HCl, pH 7.5, 1 mM EDTA.)

B) Preparation of Sample DNA from Buccal Cells

Buccal cells were collected on a sterile cytology brush (Scientific Products) or female dacron swab (Medical Packaging Corp.) by twirling the brush or swab on the inner cheek for 30 seconds. DNA was prepared as follows, immediately or after storage at room temperature or at 4° C. The brush or swab was immersed in 600 μl of 50 mM NaOH contained in a polypropylene microcentrifuge tube and vortexed. The tube, still containing the brush or swab, was heated at 95° C. for 5 min, after which the brush or swab was carefully removed. The solution containing DNA was then neutralized with 60 μl of 1M Tris, pH 8.0, and vortexed again (Mayall et al., J. Med. Genet. 27:658, 1990). The DNA was stored at 4° C.

C) Amplification of Target DNA Prior to Hybridization

DNA from patients with CF was amplified by PCR in a Perkin-Elmer Cetus 9600 Thermocycler. Five primer sets were used to simultaneously amplify relevant regions of exons 4, 10, 20, and 21 of the cystic fibrosis transmembrane conductance regulator (CFTR) gene (Richards et al., Human Mol. Gen. 2:159, 1993). The 50 μl PCR reaction mix contained the following components: 0.2-1 μg CF patient DNA, 10 mM Tris pH 8.3, 50 mM KCl, 1.5 mM MgCl2, 0.01% (w/v) gelatin, 200 μM of each deoxynucleotide triphosphate, 0.4 μM of each amplification primer, and 2.5 units of Taq polymerase. An initial denamration was performed by incubation at 94° C. for 20 seconds, followed by 28 cycles of amplification, each consisting of 10 seconds at 94° C., 10 seconds at 55° C., 10 seconds at 74° C., and a final soak at 74° C. for 5 min. Following amplification, 8 μl of the PCR products were electrophoresed in a 2% agarose gel to verify the presence of all five products.

D) Binding of DNA to a Solid Matrix

For binding of amplified DNA to a solid support, the amplification reactions described above are performed in the present of biotinylated primers. The biotinylated products are then incubated with DYNABEADS® M-280 Streptavidin magnetic beads (Dynal) in a solution containing 10 mM Tris HCl, pH 7.5, 1 mM EDTA, 2M NaCl, and 0.1% TWEEN-20™ detergent for 15-30 minutes at 48° C.

EXAMPLE 2 Hybridization of Target DNA and Wild-type DNA A) Preparation of Wild-type DNA

DNA is prepared from blood or buccal cells of healthy individuals as described in Example 1. A representative "wild-type" DNA sample is prepared by combining and thoroughly mixing DNA samples derived from 10-200 individuals.

B) Hybridization Reaction

Hybridizations are carried out in microtiter dishes containing bead-immobilized DNA prepared as in Example 1D above. The hybridization solution contains approximately 500 μg/ml wild-type DNA (prepared as in Example 2A above) and approximately 50 μg/ml amplified immobilized target DNA (prepared as in Example 1) in 10 mM Tris HCl pH 7.5-650 mM NaCl. The reaction mixtures are heated at 90° C. for 3 minutes, after which hybridizations are allowed to proceed for 1 hour at 65° C. The hybridization solution is then removed and the beads are washed three times in 0.1×SSC at 65° C.

C) Blocking of Free Ends

The beads containing DNA:DNA hybrids prepared as described above are treated so that free ends become blocked and no longer accessible to modification by, e.g., RNA ligase. The wells are incubated in 100 μl of a solution containing 0.4M potassium cacodylate, 50 mM Tris HCl, pH 6.9, 4 mM dithiothreitol, 1 mM CoCl₂, 2mM ddGTP, 500 μg/ml bovine serum albumin, and 2 units of terminal transferase for 15 minutes at 37° C.

EXAMPLE 3 Mismatch Recognition and Cleavage Using Mismatch Repair Proteins

50 ul beads containing DNA hybrids prepared as described in Example 2 are incubated with 500 units of T4 endonuclease 7 in a solution containing 50 mM Tris-HCl, pH 8.0, 10 mM MgCl₂, and 1 mM dithiothreitol for 30 minutes at 37° C. T4 endonuclease 7 is obtained as described in Kosak et al., Eur. J. Biochem. 194:779,1990.

After the incubation, the beads are heated to 90° C. for three minutes, after which the solution is quickly removed and replaced with prewarmed TE, and the beads are washed three times with TE at room temperature. This procedure effectively denatures DNA:DNA hybrids and removes wild-type DNA strands.

EXAMPLE 4 Mismatch Recognition and Cleavage Using Chemical Mismatch Cleavage

Microtiter wells prepared as described in Examples 1 and 2 above are treated sequentially with hydroxylamine and osmium tetroxide.

A) Hyroxylamine Treatment

Hydroxylamine (obtained from Aldrich, Milwaukee, Wis.) is dissolved in distilled water, and the pH is adjusted to 6.0 with diethylamine (Aldrich) so that the final concentration is about 2.5M. 200 ul of the solution are incubated within the wells at 37° C. for 2 hours. The reaction is stopped by replacing the hydroxylamine solution with an ice-cold solution containing 0.3M sodium acetate, 0.1 mM EDTA, pH5.2, and 25 μg/ml yeast tRNA (Sigma, St. Louis, Mo.). The wells are then washed in an ice-cold solution of 10 mM Tris-HCl, pH 7.7, 1 mM EDTA prior to osmium tetroxide treatment.

B) Osmium Tetroxide Treatment

Osmium tetroxide (Aldrich) is dissolved in 10 mM Tris-HCl, pH 7.7, 1 mM EDTA, and 1.5% (v/v) pyridine to a concentration of 4% (w/v). The wells are incubated with this solution for 2 hours at 37° C. The reaction is stopped by replacing the osmium tetroxide solution with an ice-cold solution containing 0.3M sodium acetate, 0.1 mM EDTA, pH5.2, and 25 μg/ml yeast tRNA.

C) Piperidine Cleavage

Chemical cleavage of the C and T bases that react with hydroxylamine or osmium tetroxide is achieved by incubating the dishes with 1M piperidine at 90° C. for 30 min. The wells are then washed extensively with distilled water.

EXAMPLE 5 Sequencing of Mismatch Regions

Immobilized DNAs prepared as described in Examples 1 and 2 above and subjected to mismatch recognition and cleavage (as described in Examples 3 or 4 above or by other methods) are incubated with a single-stranded oligonucleotide having the sequence 5'-CAGTAGTACAACTGACCCTTTTGGGACCGC-3' SEQ ID NO:1! under conditions in which efficient ligation of the oligonueleotide to free 5' ends is achieved. The oligonucleotide and immobilized DNA are combined in a solution containing 50 mM Tris HCl, pH 7.5, 10 mM MgCl₂, 20 mM dithiothreitol, 1 mM ATP, and 100 μg/ml bovine serum albumin, after which RNA ligase (Pharmacia Biotech, Uppsala, Sweden) is added to the solution to achieve a final enzyme concentration of 0.1-5.0 U/ml. The reaction is allowed to proceed at 37° C. for 15 min. Following the ligation reaction, the solution is removed, and the wells are washed with distilled water.

DNA sequencing is then performed using the Sanger method (Sanger et al., Proc. Natl. Acad. Sci. U.S.A. 74:5463, 1977).

EXAMPLE 6 Positional Cloning of a Disease-causing Gene

The experiments described below are performed to rapidly localize and sequence a genomic region corresponding to a disease-causing gene.

A multiplex family in which a genetic disease is expressed is identified using standard clinical indicators. DNA samples are obtained from affected and unaffected individuals as described in Example 1 above; if by patterns of transmission the disease appears to be an autosomal recessive syndrome, DNA samples are obtained from those individuals presumptively heterozygous for the disease gene.

All DNA samples are subjected to mismatch analysis by hybridization to wild-type DNA as described in Example 2 above. The hybrids are then treated with T4 endonuclease 7 as described in Example 3 above. Finally, an oligonucleotide having the sequence 5'-CAGTAGTACAACTGACCCTTTTGGGACCGC-3' SEQ ID NO:1! is ligated to the cleaved hybrids using RNA ligase, and the products are subjected to enzymatic DNA sequencing as described in Example 5 above.

The sequences obtained from unaffected, affected, and presumptively heterozygous family members are compared with each other and with available sequence databases, using, for example, Sequencher (Gene Codes, Ann Arbor, Mich.) and Assembly Lign (Kodak, New Haven, Conn.) The sequences are also serve as the basis for design of oligonucleotide probes, which are chemically synthesized and used to probe human genomic DNA libraries.

    __________________________________________________________________________     SEQUENCE LISTING                                                               (1) GENERAL INFORMATION:                                                       (iii) NUMBER OF SEQUENCES: 1                                                   (2) INFORMATION FOR SEQ ID NO:1:                                               (i) SEQUENCE CHARACTERISTICS:                                                  (A) LENGTH: 30 base pairs                                                      (B) TYPE: nucleic acid                                                         (C) STRANDEDNESS: single                                                       (D) TOPOLOGY: linear                                                           (ii) MOLECULE TYPE: other nucleic acid                                         (A) DESCRIPTION: /desc ="synthetic oligonucleotide"                            (iii) HYPOTHETICAL: NO                                                         (iv) ANTI-SENSE: NO                                                            (xi) SEQUENCE DESCRIPTION: SEQ ID NO:1:                                        CAGTAGTACAACTGACCCTTTTGGGACCGC30                                               __________________________________________________________________________ 

What is claimed is:
 1. A method for identifying one or more genetic alterations in a target sequence present in a DNA sample, which comprises:a) immobilizing a first DNA sample, said first DNA having a 5' end and a 3' end on a solid support under conditions such that said 5' end is bound to said support and said 3' end is unbound; b) hybridizing said immobilized sample with a second DNA having a 5' end and a 3' end wherein said second DNA does not contain the alteration(s), to form heteroduplex DNA containing a mismatch region at the site of an alteration(s); c) cleaving one or both strands of said heteroduplex adjacent to said mismatch region to form a gap at or in the vicinity of said alteration; d) subjecting said cleaved heteroduplex to conditions of denaturation to dissociate said second DNA and cleaved first DNA 3' to the site of cleavage from immobilized remaining first DNA; e) removing DNA strands cleaved in step c and dissociated in step d from said immobilized remaining first DNA; f) ligating a single-stranded oligonucleotide primer of known sequence to the unbound end of said immobilized remaining first DNA to form a ligation product; (g) treating said ligation product with a DNA polymerase and an oligonucleotide complementary to said primer of known sequence in the presence of dideoxynucleotides or four nucleotide triphosphates and determining the nucleotide sequence adjacent to the ligated primer sequence; and h) comparing said nucleotide sequence with a predetermined cognate wild-type sequence to identify said genetic alteration(s).
 2. The method of claim 1, wherein the alterations are selected from the group consisting of additions, deletions, and substitutions of one or more nucleotides and combinations thereof.
 3. The method of claim 1 further comprising blocking unbound ends on said heteroduplex DNA prior to the cleaving step.
 4. The method of claim 3, wherein the blocking step comprises a method selected from the group consisting of removal of 5' phosphate groups, homopolymeric tailing of 3' ends with dideoxynucleotides, and ligation of modified double-stranded oligonucleotides.
 5. The method of claim 1, wherein said target sequence is amplified prior to the immobilizing step.
 6. The method of claim 1, wherein the solid support is selected from the group consisting of nitrocellulose filter, nylon filter, glass beads, and plastic.
 7. The method of claim 1, wherein said cleaving step comprises exposing said heteroduplex DNA to one or more mismatch repair proteins under conditions appropriate for mismatch recognition and cleavage.
 8. The method of claim 7, wherein the one or more mismatch repair proteins are selected from the group consisting of Eschericia coli proteins MutY, MutS, MutL, MutH, and combinations thereof, or functional homologues thereof.
 9. The method of claim 8, wherein the functional homologues are derived from species selected from the group consisting of Salmonella typhimurium, Streptococcus pneumoniae, Saccharomyces cerevisiae, Schizosaccharomyces pombe, mouse and human.
 10. The method of claim 1, wherein said cleaving step comprises exposing said heteroduplex DNA to a mixture of nucleotide excision repair proteins under conditions appropriate for mismatch recognition and cleavage.
 11. The method of claim 10, wherein the mixture comprises E. coli proteins UvrA, UvrB, and UvrC, or functional homologues thereof.
 12. The method of claim 11, wherein the functional homologues are derived from species selected from the group consisting of Saccharomyces cerevisiae and human.
 13. The method of claim 1, wherein said cleaving step comprises exposing said heteroduplex DNA to one or more resolvase proteins under conditions appropriate for mismatch recognition and cleavage.
 14. The method of claim 13, wherein the resolvases are selected from the group consisting of bacteriophage T4 Endonuclease VII and bacteriophage T7 endonuclease I.
 15. The method of claim 1, wherein said cleaving step comprises the steps of:(i) exposing said heteroduplex DNA to one or more chemical reagents under conditions appropriate for mismatch recognition and modification; and (ii) contacting recognized and modified heteroduplex DNA with one or more reagents to selectively cleave one strand in the vicinity of the modification.
 16. The method of claim 15, wherein the chemical reagent is selected from the group consisting of hydroxylamine and osmium tetroxide.
 17. The method of claim 1, wherein the single-stranded oligonucleotide primer is from about 15 to about 35 nucleotides.
 18. The method of claim 1, wherein the ligating step is performed in the presence of RNA ligase.
 19. The method of claim 1, wherein the determining step is performed by enzymatic DNA sequencing.
 20. The method of claim 1, wherein the determining step is performed by hybridization to oligonucleotide arrays.
 21. A method for identifying one or more genetic alterations in a target sequence present in a genomic DNA sample, which comprises:a) immobilizing a first DNA sample, said first DNA having a 5' end and a 3' end on a solid support under conditions such that said 5' end is bound to said support and said 3' end is unbound; b) hybridizing said immobilized DNA sample with a second DNA sample, said second DNA having a 5' end and a 3' end, and wherein said second sample does not contain the alteration(s), to form heteroduplex DNA containing a mismatch region at the site of an alteration(s); c) treating said heteroduplex with terminal transferase in the presence of a dideoxynucleotide to block unbound ends thereof; d) contacting said heteroduplex with bacteriophage T4 endonuclease 7 to cleave one or both strands of said heteroduplex adjacent to said mismatch region to form a gap at or in the vicinity of said alteration; e) subjecting said cleaved heteroduplex to conditions of denaturation to dissociate said second DNA and cleaved first DNA 3' to the site of cleavage from immobilized remaining first DNA; f) removing DNA strands cleaved in step d and dissociated in step (e) from said immobilized remaining first DNA; g) ligating a single-stranded oligonucleotide primer having the sequence 5'-CAGTAGTACAACTGACCCTTTTGGGACCGC-3' (SEQ ID NO:1) to the unbound end of immobilized remaining first DNA to form a ligation product; (h) treating said ligation product with a DNA polymerase and an oligonucleotide complementary to said primer of known sequence in the presence of dideoxynucleotides or four nucleotide triphosphates and determining the nucleotide sequence adjacent to ligated primer sequence; and i) comparing said nucleotide sequence with a predetermined cognate wild-type sequence to identify said alteration(s).
 22. A method for identification of one or more mutation(s) in a DNA, which comprises:a) immobilizing one or more first DNA samples, said first DNA having a respective 5' end and a respective 3' end, on a solid support under conditions such that said 5' end is bound to said support and said 3' and is unbound; b) hybridizing said immobilized sample(s) with a second DNA sample, said second DNA having a respective 5' end and a respective 3' end, and wherein said second sample does not contain the mutation(s), to form heteroduplex DNA containing a mismatch region at the site of a mutation; c) chemically blocking unbound ends on said heteroduplex DNA; d) treating said heteroduplex DNA so that one or both strands are cleaved within or adjacent to said mismatch region to form a gap at or in the vicinity of said alteration; e) subjecting said cleaved heteroduplex to conditions of denaturation to dissociate said second DNA and cleaved first DNA 3' to the site of cleavage from immobilized remaining first DNA; f) removing DNA strands cleaved in step (d) and dissociated in step (e) from immobilized remaining first DNA; g) ligating a single-stranded oligonucleotide primer of known sequence to the unbound end of said immobilized remaining first DNA to form a ligation product; (h) treating said ligation product with a DNA polymerase and an oligonucleotide complementary to said primer of known sequence in the presence of dideoxynucleotides or four nucleotide triphosphates and determining the nucleotide sequence adjacent to ligated primer sequence; and i) comparing said nucleotide sequence with one or more predetermined cognate wild-type sequences to identify said mutation(s).
 23. A method for multiplex identification of one or more mutations in a DNA, the method comprising:a) obtaining one or more first DNA samples, said DNA having a respective 5' end and a respective 3' end; b) amplifying one or more target sequences in each of said samples; c) immobilizing said amplified sequences on a solid support under conditions such that said 5' end is bound to said support and said 3' end is unbound; d) hybridizing said immobilized sample(s) with a second DNA sample, said second DNA having a respective 5' end and a respective 3' end, and wherein said second sample does not contain the mutation(s), to form heteroduplex DNA containing a mismatch region at the site of a mutation; e) chemically blocking unbound ends on said heteroduplex DNA; f) treating said heteroduplex DNA so that one or both strands are cleaved within or adjacent to said mismatch region to form a gap at or in the vicinity of said mutation; g) subjecting said cleaved heteroduplex to conditions of denaturation to dissociate said second DNA and cleaved first DNA 3' to site of cleavage from immobilized remaining first DNA; h) removing DNA strands cleaved in step (f) and dissociated in step (g) from said immobilized remaining first DNA; i) ligating a single-stranded oligonucleotide primer of known sequence to the unbound end of said immobilized remaining first DNA to form a ligation product; (j) treating said ligation product with a DNA polymerase and an oligonucleotide complementary to said primer of known sequence in the presence of dideoxynucleotides or four nucleotide triphosphates and determining the nucleotide sequence adjacent to ligated primer sequence; and k) comparing said nucleotide sequence with one or more predetermined cognate wild-type sequences to identify said mutation(s).
 24. The method of claim 1 wherein the DNA samples are denatured prior to hybridization.
 25. The method of claim 21 wherein the DNA samples are denatured prior to hybridization.
 26. The method of claim 22 wherein the DNA samples are denatured prior to hybridization.
 27. The method of claim 23 wherein the DNA samples are denatured prior to hybridization.
 28. A method for positional cloning of a gene of interest, the method comprising:a) immobilizing a first DNA sample from an individual displaying a given phenotype, said first DNA having a 5' end and a 3' end on a solid support under conditions such that said 5' end is bound to said support and said 3' end unbound; b) hybridizing said immobilized sample with a second DNA sample, said second DNA having a 5' end and a 3' end, and wherein said second DNA sample is from one or more individual(s) not displaying said phenotype to form heteroduplex DNA containing a mismatch region at the site of a genetic alteration; c) cleaving one or both strands of said heteroduplex DNA to form a gap at or in the vicinity of said alteration; d) subjecting said cleaved heteroduplex to conditions of denaturation to dissociate said second DNA from said first DNA; e) removing DNA strands cleaved in step (c) and dissociated in step (d) from said first DNA; f) ligating a single-stranded oligonucleotide primer of known sequence to the 3' end of first cleaved DNA to form a ligation product; g) treating said ligation product with a DNA polymerase and an oligonucleotide complementary to said primer of known sequence in the presence of dideoxynucleotides or four nucleotide triphosphates and determining the nucleotide sequence adjacent to ligated primer sequence; h) preparing a synthetic oligonucleotide comprising all or part of said determined nucleotide sequence; and i) identifying a DNA clone that hybridizes to said oligonucleotide.
 29. The method of claim 28 which comprises chemically blocking free terminal ends of said heteroduplex prior to said cleaving steps.
 30. The method of claim 28, wherein the genetic alterations are selected from the group consisting of additions, deletions, and substitutions of one or more nucleotides and combinations thereof.
 31. The method of claim 28, wherein the cleaving step comprises exposing the heteroduplex DNA to a mixture of mismatch repair proteins under conditions appropriate for mismatch recognition and cleavage.
 32. The method of claim 31, wherein the mismatch repair proteins are selected from the group consisting of Escherichia coli proteins MutY, MutS, MutL, MutH, and combinations thereof, or functional homologues thereof.
 33. The method of claim 32, wherein the functional homologues are from species selected from the group consisting of Salmonella typhimurium, Streptococcus pneumoniae, Saccharomyces cerevisiae, Schizosaccharomyces pombe, mouse and human.
 34. The method of claim 28, wherein the cleaving step comprises exposing the heteroduplex DNA to a mixture of nucleotide excision repair proteins under conditions appropriate for mismatch recognition and cleavage.
 35. The method of claim 34, wherein the mixture comprises Escherichia coli proteins UvrA, UvrB, and UvrC, or functional homologues thereof.
 36. The method of claim 35, wherein the functional homologues are from species selected from the group consisting of Saccharomyces cerevisiae and human.
 37. The method of claim 28, wherein the cleaving step comprises exposing the heteroduplex DNA to one or more resolvase proteins under conditions appropriate for mismatch recognition and cleavage.
 38. The method of claim 37, wherein the resolvases are selected from the group consisting of bacteriophage T4 Endonuclease VII and bacteriophage T7 endonuclease I.
 39. The method of claim 28, wherein the cleaving step comprises the steps of:(i) exposing the heteroduplex to one or more chemical reagents under conditions appropriate for mismatch recognition and modification; and (ii) contacting said recognized and modified heteroduplex DNA with one or more reagents to selectively cleave one strand in the vicinity of the alteration.
 40. The method of claim 39, wherein the chemical reagent is selected from the group consisting of hydroxylamine and osmium tetroxide.
 41. The method of claim 28, wherein the single-stranded oligonucleotide primer is from about 15 to about 35 nucleotides.
 42. The method of claim 28, wherein the ligating step is performed in the presence of RNA ligase.
 43. The method of claim 28, wherein the determining step performed by enzymatic DNA sequencing.
 44. The method of claim 28, wherein the determining step is performed by hybridization to oligonucleotide arrays.
 45. The method of claim 28, wherein the identifying step is achieved using a method selected from the group consisting of colony hybridization, identification of tissue-specific expression, reverse transcription-amplification of mRNA, and screening of an affected population for genotype/phenotype association.
 46. The method of claim 28, wherein the DNA samples are denatured prior to hybridization.
 47. The method of claim 28, wherein the first DNA is immobilized on a solid support under conditions such that said 5' end is bound to said support and said 3' end is unbound. 